Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-07T23:57:28.376Z Has data issue: false hasContentIssue false
  • English
  • Français

The Current Age of Youthful Melancholia

Evidence for Increase in Depression Among Adolescents and Young Adults

Published online by Cambridge University Press:  02 January 2018

Gerald L. Klerman
Gerald L. Klerman*
Affiliation:
Department of Psychiatry, Cornell University Medical Center
*
Ms Lorraine Lubin, Editorial Assistant to Dr Klerman, NY Hospital-Cornell Medical College, Westchester Division, 21 Bloomingdale Road, White Plains, NY 10605, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

The possibility of a rise in rates of depression among adolescents and young adults was first reported in the 1970s. Particular note was taken of the emergence of childhood depression and the increase in suicide attempts and death among adolescents and young adults. Data from large-sample family studies and community epidemiological surveys have been reviewed and reanalysed, using life-table statistical methodology. Evidence for secular trends are presented, and the problems of disentangling period and cohort effect are discussed. It appears that the ‘baby boomers' -those born in the years after World War II- have had increased rates of depression and other related illnesses, including drug abuse and alcoholism. The theoretical aspects of this are discussed, particularly for gene-environment interactions.

Type
Papers
Information
The British Journal of Psychiatry , Volume 152 , Issue 1 , January 1988 , pp. 4 - 14
Copyright
Copyright © The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Presented in part as the third Eli Lilly Lecture to the Royal College of Psychiatrists, London, 27 January 1987.

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: American Psychiatric Association.Google Scholar
Borland, D. C. (1982) A cohort analysis approach to the ‘empty nest’ syndrome among three ethnic groups of women: a theoretical position. Journal of Marriage and Family, 117–129.CrossRefGoogle Scholar
Case, R. A. M. (1956) Cohort analysis of mortality rates as an historical or narrative technique. British Journal of Preventive Social Medicine, 10, 159–171.Google Scholar
Cormier, H. J. & Klerman, G. L. (1985) Unemployment and male-female labor force participation as determinants of changing suicide rates of males and females in Quebec. Social Psychiatry, 20, 109–114.CrossRefGoogle ScholarPubMed
Crow, T. J. (1986) Secular changes in affective disorder and variations in the psychosis gene. Archives of General Psychiatry, 43, 1013–1014.CrossRefGoogle ScholarPubMed
Day, N. E. & Charnay, B. (1982) Time trends, cohort effects and aging as influence on cancer incidence. In Trends in Cancer Incidence (ed. K. Magnus). New York, Washington, DC: Hemisphere.Google Scholar
Easterlin, R. A. (1980) Birth and Fortune. New York: Basic Books.Google Scholar
Easterlin, R. A. (1985) The struggle for economic status. Presented at the conference on Non-Replacement Fertility, Hoover Institution, Stanford University, CA, 1985.Google Scholar
Easterlin, R. A. (1986) “Easterlin Hypothesis”. New Palgrave. London: Macmillan Press.Google Scholar
Endicott, J. & Spitzer, R. (1978) A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Feinberg, S. E. & Mason, W. M. (1983) Discrete archival data: age period cohort effects for vital rates. Biometrics, 39, 311–324.Google Scholar
Fowler, R. C., Rich, C. L. & Young, D. (1986) San Diego Suicide Study: II. Substance abuse in young cases. Archives of General Psychiatry, 43, 962–968.Google Scholar
Frost, W. H. (1939) The age selection of mortality from tuberculosis in successive decades. American Journal of Hygiene, 30, 91–96.Google Scholar
Gershon, E. S., Hamovit, J. & Guroff, J. (1982) A family study of schizophrenia, bipolar I, bipolar II, unipolar and normal controls. Archives of General Psychiatry, 39, 1157–1167.CrossRefGoogle Scholar
Goldman, N., Westoff, C. F. & Hammerslough, C. (1984) Demography of the marriage market in the United States. Population Index, 50, 5–25.CrossRefGoogle ScholarPubMed
Goldney, R. D. & Katsikitis, M. (1983) Cohort analysis of suicide rates in Australia. Archives of General Psychiatry, 40, 71–74.CrossRefGoogle ScholarPubMed
Guttentag, M. & Secord, P. F. (1983) Too Many Women: The Sex Ratio Question. Beverly Hills: Sage Publications.Google Scholar
Hafner, H. (1985) Are mental disorders increasing over time? Psychobiology, 18, 66–81.Google Scholar
Hagnell, O. (1982) The 25 year follow-up of the Lundby Study: incidence and risk of alcoholism, depression and disorders of the senium. In Mental Disorders in the Community (eds J. Barrett & R. M. Rose). New York: Guilford Press.Google Scholar
Hagnell, O., Lanke, j., Rorsman, B. & Ojesjo, L. (1982) Are we entering an age of melancholy? Depressive illnesses in a prospective epidemiological study over 25 years: the Lundby Study, Sweden. Psychological Medicine, 12, 279–289.CrossRefGoogle Scholar
Hallstrom, T. (1984) Point prevalence of major depressive disorder in a Swedish urban female population. Acta Psychiatrica Scandinavica, 69, 52–59.CrossRefGoogle Scholar
Hogan, D. P. (1981) Transition and Social Change: the Early Lives of American Men. New York: Academic Press.Google Scholar
Holford, T. R. (1983) The estimation of age, period and cohort effects for vital rates. Biometrics, 39, 311–324.Google Scholar
Holinger, P. C. & Offer, D. (1982) Prediction of adolescent suicide: a population model. American Journal of Psychiatry, 139, 302–306.Google Scholar
Holinger, P. C., Offer, D. & Zola, M. A. (1987) A prediction model of suicide among youth. Science (in press).Google Scholar
Katz, M. M. & Klerman, G. L. (1979) Introduction overview of the Clinical Studies Program of the NIMH Clinical Research Branch Collaborative Study on the Psychobiology of Depression. American Journal of Psychiatry, 136, 49–51.Google Scholar
Katz, M. M., Klerman, G. L., Secunda, S. K., Hirschfield, R. M. A. & Koslow, S. H. (1979) NIMH Clinical Research Branch Collaborative Program on the psychobiology of depression. Archives of General Psychiatry, 36, 765–771.Google Scholar
Klerman, G. L. (1976) Age and clinical depression: today's youth in the 21st century. Journal of Gerontology, 31, 318–323.Google Scholar
Klerman, G. L. (1979) The age of melancholy. Psychology Today, 12, 36–42, 88.Google Scholar
Klerman, G. L. (1980a) Homicide among black males: concluding remarks. Public Health Reports No. 6, 95, 549–550.Google Scholar
Klerman, G. L. (1980b) Adaptation, depression and transitional life events. In Adolescent Psychiatry (eds S. C. Feinstein, P. L. Govacchini, P. L. J. Golooney and A. Z. Schwartzberg). Chicago, Illinois: Chicago University Press.Google Scholar
Klerman, G. L. (1986a) Evidence for increases in rates of depression in North America and Western Europe in recent decades. In New Results in Depression Research (eds H. Hippius, G. L. Klerman and N. Matussek). Berlin/Heidelberg/New York: Springer.Google Scholar
Klerman, G. L. (ed.) (1986b) Suicide and Depression Among Adolescents and Young Adults. Washington, DC: American Psychiatric Press.Google Scholar
Klerman, G. L. (1986c) The National Institute of Mental Health- Epidemiologic Catchment Area (NIMH-ECA) Program. Social Psychiatry, 21. 159 166.CrossRefGoogle ScholarPubMed
Klerman, G. L., Lavori, P. W., Rice, J., Reich, T., Endicott, J., Andreasen, N. C., Keller, M. B. & Hirschfeld, R. M. A. (1985) Birth cohort trends in rates of major depressive disorder among relatives of patients with affective disorder. Archives of General Psychiatry, 42, 689–695.Google Scholar
Kovaks, M., Feinberg, T. L., Crouse-Novak, M. A., Paulauskas, S. L. & Finkelstein, R. (1984) Archives of General Psychiatry, 41, 229–237.Google Scholar
Kramer, M., Zubin, J. & Cooper, J. E. (1969) Cross-national study of diagnosis of the mental disorders. American Journal of Psychiatry, 125, Suppl., 1–46.Google Scholar
Lavori, P., Klerman, G. L., Keller, M., Reich, T., Rice, J. & Endicott, J. (1987) Age period cohort analyses of secular trends in onset of major depression: findings in siblings of patients with major affective disorder. Journal of Psychiatric Research, 21, 23–35.Google Scholar
Leighton, D., Harding, J. etal (1963) Psychiatric findings of the Stirling County study. American Journal of Psychiatry, 119, 1021–1031.CrossRefGoogle Scholar
MacMahon, B., Johnson, S. & Pugh, T. F. (1963) Relationship of suicide rates to social conditions. Public Health Report, 78, 285–293.Google Scholar
MacMahon, B., Johnson, S., Pugh, T. F., B. & Pugh, T. F. (1970) Epidemiology: Principles and Methods. Boston: Little Brown.Google Scholar
Magnus, K. (ed.) (1982) Trends in Cancer Incidence. New York, Washington, DC: Hemisphere.Google Scholar
Murphy, G. E. & Wetzel, R. D. (1980) Suicide risk by birth cohort in the United States. Archives of General Psychiatry, 37, 519–523.Google Scholar
Murphy, G. E., Wetzel, R. D., J. M., Sobol, A. M., Neff, R. K., Olivier, D. C. & Leighton, A. H. (1984) Stability of prevalence. Archives of General Psychiatry, 41, 990–997.CrossRefGoogle ScholarPubMed
Murphy, G. E., Wetzel, R. D., J. M., Sobol, A. M., Neff, R. K., Olivier, D. C., Leighton, A. H., E., Lindesay, J. & Grundy, E. (1986a) 60 years of suicide in England and Wales. Archives of General Psychiatry, 43, 969–977.Google Scholar
Murphy, G. E., Wetzel, R. D., J. M., Sobol, A. M., Neff, R. K., Olivier, D. C., Leighton, A. H., E., Lindesay, J., Grundy, E., J. M., Olivier, D. C., Sobol, A. M., Monson, R. R. & Leighton, A. H. (1986b) Diagnosis and outcome: depression and anxiety in a general population. Psychological Medicine, 16, 117–126.CrossRefGoogle ScholarPubMed
Neugarten, B. L. (1975) Adult personality: toward a psychology of the life cycle. In Human Life Cycle (ed. W. C. Sze). New York: James Aronson.Google Scholar
Offer, D., Ostrov, E. & Howard, K. I. (1984) Epidemiology of mental health illness among adolescents. In Significant Advances in Child Psychiatry (ed. J. Call). New York: Basic Books.Google Scholar
O'Malley, P. M., Bachman, J. G. & Johnston, L. D. (1984) Period, age and cohort effects on substance use among American youth, 1976–82. American Journal of Public Health, 74, 682–688.Google Scholar
Regier, D. A., Myers, J. K., Kramer, M., Robins, L. N., Blazer, D. G., Hough, R. L., Eaton, W. W. & Locke, B. Z. (1984) The NIMH epidemiologic catchment area program. Archives of General Psychiatry, 41, 934–941.Google Scholar
Reich, T., van Eerdewegh, P., Rice, J. & Mullaney, J. (1987) The familial transmission of primary major depressive disorder. Journal of Psychiatric Review (in press).Google Scholar
Rice, J., Reich, T. & Andreasen, N. C. (1984) Sex-related differences in depression: familial evidence. Journal of Affective Disorders, 7, 199–210.Google Scholar
Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E., Burke, J. D. & Regier, D. A. (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949–958.Google Scholar
Sartorius, N., Davidian, H., Ernberg, G., Fenton, F. R., Fujii, I. et al (1983) Depressive Disorders in Different Cultures: Report on the WHO Collaborative Study on Standardized Assessment of Depressive Disorders. Geneva: World Health Organization.Google Scholar
Scarf, M. (1980) Unfinished Business. New York: Basic Books.Google Scholar
Schwab, J. J. (1974) Perception of social change and depressive symptomatology. In Social Psychiatry, Vol. 1 (eds J. H. Masserman & J. J. Schwab). New York: Grune and Stratton.Google Scholar
Solomon, M. I. & Hellon, C. P. (1980) Suicide and age in Alberta, Canada, 1951–1977. Archives of General Psychiatry, 37, 511–513.Google Scholar
Srole, L. & Fischer, A. K. (1980) The Midtown Manhattan longitudinal study vs the Mental Paradise Lost Doctrine. Archives of General Psychiatry, 37, 209–221.Google Scholar
Susser, M., Watson, W. & Hopper, K. (1985) Sociology in Medicine (3rd edn). New York/Oxford: Oxford University Press.Google Scholar
Weissman, M. M. (1979) Myth of involutional melancholia. Journal of American Medical Association, 242, 742–744.Google Scholar
Weissman, M. M. & Klerman, G. L. (1977) Sex differences and the epidemiology of depression. Archives of General Psychiatry, 34, 98–111.CrossRefGoogle ScholarPubMed
Weissman, M. M., Klerman, G. L. & Myers, J. K. (1978) Affective disorders in a United States urban community: the use of Research Diagnostic Criteria in an epidemiologic survey. Archives of General Psychiatry, 35, 1304–1311.Google Scholar
Weissman, M. M., Klerman, G. L., Myers, J. K., Leaf, P. J., Holzer, C. E. III, Myers, J. K. & Tischler, G. L. (1984) The epidemiology of depression: an update on sex differences in rates. Journal of Affective Disorders, 7, 179–188.Google Scholar
Weissman, M. M., Klerman, G. L., Myers, J. K., Leaf, P. J., Holzer, C. E. III, Myers, J. K., Tischler, G. L., Myers, J. K., Leaf, P. J., Tischler, G. L. & Holzer, C. E. (1986) The affective disorders: results from the Epidemiologic Catchment Area (ECA). In New Results in Depression Research (eds. H. Hippius, G. L. Klerman & N. Matussek). Berlin/Heidelberg: Springer.Google Scholar
Weissman, M. M., Klerman, G. L., Myers, J. K., Leaf, P. J., Holzer, C. E. III, Myers, J. K., Tischler, G. L., Myers, J. K., Leaf, P. J., Tischler, G. L., Holzer, C. E., Leaf, P. J., Tischler, G. L. et al (1987) Affective disorders in 5 United States communities. Psychological Medicine (in press).Google Scholar
Wickramaratne, P. J., Weissman, M. M., Leaf, P. J. & Holford, T. R. (1987) Age, period cohort effects on the risk of major depression: resuhs from 5 United States communities (in press).Google Scholar
Williams, P. & King, M. (1987) The epidemic of anorexia nervosa: another medical myth? The Lancet, i, 205–207.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.